[Distinct clinical characteristics of inflammatory bowel disease in children younger than 5 years].
In the last decades an increase in morbidity of inflammatory bowel disease, particularly of Crohn disease, in children has been observed.


OBJECTIVE
Assessment of clinical course and activity of inflammatory bowel disease in children younger than 5 years was the goal of the study.


METHODS
The study comprised 21 children aged 2 to 5 years (13 boys and 8 girls) who were diagnosed with: Leśniowski-Crohn disease (7 children), ulcerative colitis (7 children) and indeterminate colitis (remaining 7 children).


RESULTS
Among studied children boys prevailed (61.9%). In 6 children the disease started in the first and second year of life; the average age of disease onset was 26.9 months and the time between the onset of the disease and the diagnosis was 16.6 months. 46% of patients came from the cities with population above 100000 when only 23% lived in the country. Autoimmune diseases were diagnosed in the families of 6 children, food or pollen allergy in the families of 11 children. Abdominal pain, diarrhea, presence of blood and mucous in the stool, fever and lack of thrive were most apparent in the clinical picture. The pathological changes were present mainly in the large intestine and only in one case in the upper part of the alimentary tract and jejunum. The observed course of the disease was severe or moderate. In two children aged 3 years colectomy was performed.


CONCLUSIONS
In children younger than 5 years severe and moderate course of the Leśniowski-Crohn disease and ulcerative colitis is apparent. Fever, abdominal pain, diarrhea, presence of blood and mucous in the stool and lack of appetite were the most often seen symptoms. Pathological changes in children younger than 5 years were present mainly in the large intestine and only in single cases in the upper part of the alimentary tract and jejunum. In children with inflammatory bowel disease a frequent occurrence of allergy, bronchitis, pneumonia and urinary tract infection, which required antibiotics, was observed.
Iwańczak
Barbara
B
Akademia Medyczna we Wrocławiu, II Katedra i Klinika Pediatrii, Gastroenterologii i Zywienia. barbara@iwanczak.com
Kofla-Dłubacz
Anna
A
Mowszet
Krystyna
K
Pytrus
Tomasz
T
Krzesiek
Elzbieta
E
Iwańzak
Franciszek
F
D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000235:genetics; D001991:Bronchitis / Q000150:complications; D002675:Child, Preschool; D003092:Colitis / Q000175:diagnosis; D003093:Colitis, Ulcerative / Q000175:diagnosis; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D011014:Pneumonia / Q000150:complications; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000175:diagnosis; D014552:Urinary Tract Infections / Q000150:complications